Asthma Doesn't Have To PutKids On The Sidelines Anymore

Published: November 29, 1999 12:00 AM

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It is the most common disease among children.

It is the cause of more missed school days than any other chronic condition.

It is asthma. The Centers for Disease Control reported that 17.3 million people had asthma during 1998. The estimate of the number of cases in Ohio from the CDC for 1998, the last year that data is available, is 748,200. The American Lung Association reports that 4.8 million children under 18 have asthma.

Wooster physician Dr. Robert Sibilia defined asthma as a chronic condition where the airway is inflamed. The cause of the disease is not known, but Sibilia said there are certain triggers that can cause an attack. "Allergies, smoke, excessive cold, infections can all trigger an attack," he said.

These triggers cause the airway to tighten. It also causes inflammation which produces phlegm which is coughed up during an attack.

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"Over the past 10 years, treatment plans have changed. We are working to reduce the symptoms so when a patient encounters a trigger, their symptoms will not be so bad," he said.

One change Sibilia noted is treating asthma at the first sign of symptoms. "We are using higher potency medications and there is more use of steroids in treatment," he said. Sibilia said there are four categories of asthma: mild intermittent, when a person has problems three to four times in a year; mild persistent, characterized by night coughing two to four times a week; moderate persistent, when a person is on medication; and severe persistent, when a patient has active symptoms on a daily basis and also has multiple triggers for an attack.

Sibilia's new treatment plans have been effective for 14-year-old Shawn Patrick Frazier of Fredericksburg. He was diagnosed with the disease during his early grade school years.

"Since he has an inhaler with him all the time and a breathing machine at home, he hasn't been to the emergency room in over two years," said Frazier's mother, Diana. Sibilia, who is board certified in internal medicine, pediatrics and pulmonology, aggressively treats his patients' symptoms and said that education of both parent and patient is vital to controlling the disease.

"All patients and parents have an emergency plan if the rescue medicines (typically an inhaler or breathing treatment) do not help," Sibilia said.

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Sibilia said he wants his patients to get to a point where they are bored with their disease. "I want them to take their medicine, do their daily activities and not think about their disease," he said. "They should definitely play sports and should not tailor their level of activity to their disease," Sibilia said.

Shawn is active in soccer, wrestling, Boy Scouts and played baseball when he was younger. "Sometimes when I have trouble I have to sit out of practice," Shawn said. He missed several soccer practices last season, but has stayed active, which Sibilia says is important in controlling his disease. "Olympic athletes who have asthma have achieved great things and have not let their disease stop them," Sibilia said. Frazier's mother admits her son gets tired of having asthma and he gets frustrated when he has to miss practices or conditioning for wrestling, but he continues to try and stay active.

If Shawn plays soccer outside on a cold day, he must deal with two triggers for his disease, allergens in the air and the cold. "It's like a snowball effect," Diana said.

The attack can become progressively worse if Shawn comes in contact with several triggers. One way to control his attacks is to limit the amount of dust and other allergens in his room. "I tell him to clean his room, but every time he comes home from school or practice, he has stuff on his clothes and shoes. It is very hard to keep up," Diana said.

Over the years, Shawn has had to answer questions about what is wrong with him if he has to sit out of gym class. "Most people just want to know what is wrong and want to know more about asthma," Shawn said. He added that kids have rarely made fun of him when he cannot participate with the rest of his class.

The fear of having an asthma attack, which can in extreme cases result in death, has not really bothered Shawn. "The only time I have ever really been scared was when I was camping with Scouts," he said. "I was afraid I would get out and not be able to get back in time to get help, if I had an attack."

Sibilia said that many people suffer needlessly with asthma. "There is so much we can do for asthma now. We can manage symptoms and get people on a treatment plan to control their symptoms," he said.

Sibilia will be presenting a public health service program at Wooster Community Hospital titled, "Prevention and Management of Childhood Asthma," Tuesday at 7 p.m. Also at 6 p.m. Sibilia will give a program on symptoms and treatment of breathing disorders including adult onset asthma, chronic bronchitis and chronic obstructive pulmonary disease. For more information or to register, call at 263-8144.